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Eshrati R, Jafari M, Gudarzi S, Nazari A, Samizadeh E, Ghafourian Hesami M. Comparison of ameliorative effects of Taraxacum syriacum and N-acetylcysteine against acetaminophen-induced oxidative stress in rat liver and kidney. J Biochem 2021; 169:337-350. [PMID: 32970799 DOI: 10.1093/jb/mvaa107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 09/08/2020] [Indexed: 11/13/2022] Open
Abstract
Taraxacum syriacum (TS) with natural antioxidant and pharmacological activities may be considered for treatment of oxidative stress induced by acetaminophen (APAP). The aim of this study was to evaluate the ameliorative effects of the ethanol extract of TS root against hepatorenal toxicity induced by APAP in comparison to N-acetylcysteine (NAC) as a standard drug. Thirty male Wistar rats were randomly divided into five groups. Control group; APAP (1 g/kg) group; APAP-NAC (160 mg/kg) group and APAP-TS100 and APAP-TS200 groups: APAP plus 100 and 200 mg/kg of TS extract, respectively. After 7 days treatment, serum and liver and kidney tissues were prepared and evaluated. TS extract ameliorated the increased lipid peroxidation level and decreased antioxidant enzymes activities and glutathione level in liver and kidney of APAP-treated rats. Moreover, treatment with the TS extract caused significant reduction in the histopathological damages and high levels of serum biochemical markers of hepatic and renal functions after APAP treatment. This study suggests that the extract of TS roots has dose-dependent ameliorative effect against APAP-induced oxidative damage in liver and kidney due to its free radical scavenging and antioxidant properties. The overall efficacy of the extract at 200 mg/kg dose is comparable with NAC.
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Affiliation(s)
- Reza Eshrati
- Department of Biochemistry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahvash Jafari
- Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Saeed Gudarzi
- Department of Biochemistry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Afshen Nazari
- Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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Laghrib F, Hammani H, Farahi A, Lahrich S, Aboulkas A, El Mhammedi MA. Electrochemical Determination of Paracetamol in Blood and Pharmaceutical Formulations Using Activated Carbon Electrode. RUSS J ELECTROCHEM+ 2021. [DOI: 10.1134/s1023193520120101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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3
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Pergolizzi JV, Magnusson P, LeQuang JA, Breve F, Taylor R, Wollmuth C, Varrassi G. Can NSAIDs and Acetaminophen Effectively Replace Opioid Treatment Options for Acute Pain? Expert Opin Pharmacother 2021; 22:1119-1126. [PMID: 33689517 DOI: 10.1080/14656566.2021.1901885] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Opioid analgesia for acute painful conditions has come under increasing scrutiny with the public health crisis of opioid overdose, leading clinicians to seek nonopioid alternatives, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (paracetamol). AREAS COVERED This perspective evaluates recent clinical trials of nonopioids, opioids, and combination therapy for use in acute pain. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) often provide adequate analgesia, although these agents are not without risks. Combination therapy using a small amount of opioid together with a nonopioid pain reliever has been shown effective and reduces opioid consumption. EXPERT OPINION The short-term use of opioids under close clinical supervision, such as in-hospital use of opioid analgesics for postoperative pain, may be appropriate, but even here, combination therapy or nonopioid therapy may be preferred. The use of opioids even for acute pain of short duration has been questioned. The ideal analgesic has yet to be developed, but effective pain control pharmacological regimens for acute pain are available.
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Affiliation(s)
| | - Peter Magnusson
- Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden.,Cardiology Research Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | | | - Frank Breve
- Department of Pharmacy, Temple University, Philadelphia, Pennsylvania, USA
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Bhagyashri B. Kamble, Tawade AK, Kamble P, Padavi MN, Sharma KKK, Ajalkar BD, Tayade SN. Hydrothermal Assisted Synthesis of Micro-Bricks Shaped WO3 for Electrochemical Oxidation of Paracetamol: A Microstructured Paracetamol Sensor. RUSS J ELECTROCHEM+ 2020. [DOI: 10.1134/s1023193520050043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Palakollu VN, Chiwunze TE, Liu C, Karpoormath R. Electrochemical sensitive determination of acetaminophen in pharmaceutical formulations at iron oxide/graphene composite modified electrode. ARAB J CHEM 2020. [DOI: 10.1016/j.arabjc.2019.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Chipeture AT, Apath D, Moyo M, Shumba M. Multiwalled carbon nanotubes decorated with bismuth (III) oxide for electrochemical detection of an antipyretic and analgesic drug paracetamol in biological samples. J Anal Sci Technol 2019. [DOI: 10.1186/s40543-019-0181-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Castro L, Nazal L, Silva G, Brahm J, Segovia R, Ferrario M, Buckel E, Uribe M, Puelma F, Regueira T, Reccius A, Fardella P, Rodríguez MDLÁ, Blamey R. MANEJO DE LA FALLA HEPÁTICA FULMINANTE: PROPUESTA DE PROTOCOLO EN CLÍNICA LAS CONDES. REVISTA MÉDICA CLÍNICA LAS CONDES 2019. [DOI: 10.1016/j.rmclc.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Benlamkaddem S, Iken I, Houari N, Elbouazzaoui A, Boukatta B, Sbai H, Achour S, Kanjaa N. Paracetamol self-poisoning: when oral N-acetylcysteine saves life? a case report. Pan Afr Med J 2018; 29:83. [PMID: 29875964 PMCID: PMC5987070 DOI: 10.11604/pamj.2018.29.83.10595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/14/2017] [Indexed: 11/17/2022] Open
Abstract
Paracetamol is the most widely drug involved in accidental paediatric exposures and deliberate self-poisoning cases because of its availability. N-acetyl cystein is the main treatment for this poisoning. We report a case of a 24-year-old Arab female who has deliberately ingested 100 tablets of 500 mg paracetamol each (50g). Her first examination was normal. She has received oral N-acetyl cystein (NAC) 6 hours after the ingestion. Serum paracetamol level done 18 hours post ingestion was 900 mg/l. On review the next days, she did not develop any symptoms of liver failure. However, due to the massive paracetamol ingestion associated with high serum paracetamol levels, oral NAC was continued for 3 days. The patient was discharged well on the fifth day of hospitalization. Our patient has ingested one of the highest paracetamol overdose (50g) with the highest paracetamol blood levels ever reported in medical literature. She was treated, six hours after ingestion, with oral NAC for 3 days without any side effects.
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Affiliation(s)
| | - Imane Iken
- Laboratory of toxicology, Hassan II University Hospital, Fez, Morocco
| | - Nawfal Houari
- Intensive Care Unit, Hassan II University Hospital, Fez, Morocco
| | | | - Brahim Boukatta
- Intensive Care Unit, Hassan II University Hospital, Fez, Morocco
| | - Hicham Sbai
- Intensive Care Unit, Hassan II University Hospital, Fez, Morocco
| | - Sanae Achour
- Laboratory of toxicology, Hassan II University Hospital, Fez, Morocco
| | - Nabil Kanjaa
- Intensive Care Unit, Hassan II University Hospital, Fez, Morocco
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9
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Abstract
Drug-induced liver injury (DILI) is an important cause of hospitalisation and of medication deregistration. In old age, susceptibility to DILI is affected by changes in physiology and increased interindividual variability, compounded by an increased prevalence of disease and the frailty syndrome. While dose-related or predictable DILI reactions are often detected in preclinical trials, the occurrence of rare hypersensitivity or idiosyncratic reactions cannot be reliably predicted from preclinical studies or even by clinical trials. The limited participation of older adults in clinical trials means that the susceptibility of this population to DILI is largely unknown. Vigilance during clinical trials and postmarketing surveillance must be universally practised. A systematic approach should be taken to determine not only which medicines are hepatotoxic and should be removed from the market, but also the hepatotoxicity risks from marketed drugs to consumers with different characteristics, many of whom are older people.
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Affiliation(s)
- Sarah J Mitchell
- Sydney Medical School, University of Sydney, and Departments of Clinical Pharmacology and Aged Care and Rehabilitation, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Sarah N Hilmer
- Departments of Clinical Pharmacology and Aged Care and Rehabilitation, Ward 11C Main Building, Royal North Shore Hospital, Pacific Highway, St Leonards NSW 2065, Australia
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Vatakuti S, Schoonen WGEJ, Elferink MLG, Groothuis GMM, Olinga P. Acute toxicity of CCl4 but not of paracetamol induces a transcriptomic signature of fibrosis in precision-cut liver slices. Toxicol In Vitro 2015; 29:1012-20. [PMID: 25858767 DOI: 10.1016/j.tiv.2015.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/10/2015] [Accepted: 03/18/2015] [Indexed: 12/20/2022]
Abstract
In rat in vivo, both paracetamol (APAP) and carbon tetrachloride (CCl4) induce liver necrosis, but long-term treatment with CCl4, in contrast to paracetamol, causes liver fibrosis. The aim of this study was to perform transcriptomic analysis to compare the early changes in mRNA expression profiles induced by APAP and CCl4 in the rat precision-cut liver slice model (PCLS) and to identify early markers that could predict fibrosis-inducing potential. Microarray data of rat PCLS exposed to APAP andCCl4was generated using a toxic dose based on decrease in ATP levels. Toxicity pathway analysis using a custom made fibrosis-related gene list showed fibrosis as one of the predominant toxic endpoints in CCl4-treated, but not in APAP-treated PCLS. Moreover, genes which have a role in fibrosis such as alpha-B crystallin, jun proto-oncogene, mitogen-activated protein kinase 6, serpin peptidase inhibitor and also the transcription factor Kruppel-like-factor-6 were up-regulated by CCl4, but not by APAP. Predicted activation or inhibition of several upstream regulators due to CCl4 is in accordance with their role in fibrosis. In conclusion, transcriptomic analysis of PCLS successfully identified the fibrotic potential of CCl4 as opposed to APAP. The application of PCLS as an ex vivo model to identify early biomarkers to predict the fibrogenic potential of toxic compounds should be further explored.
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Affiliation(s)
- Suresh Vatakuti
- Division of Pharmacokinetics, Toxicology and Targeting, Department of Pharmacy, Groningen Research Institute for Pharmacy, University of Groningen, Groningen, The Netherlands
| | | | - Marieke L G Elferink
- Division of Pharmacokinetics, Toxicology and Targeting, Department of Pharmacy, Groningen Research Institute for Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Geny M M Groothuis
- Division of Pharmacokinetics, Toxicology and Targeting, Department of Pharmacy, Groningen Research Institute for Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Peter Olinga
- Division of Pharmaceutical Technology and Biopharmacy, Department of Pharmacy, Groningen Research Institute for Pharmacy, University of Groningen, Groningen, The Netherlands.
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Gowda JI, Gunjiganvi DG, Sunagar NB, Bhat MN, Nandibewoor ST. MWCNT–CTAB modified glassy carbon electrode as a sensor for the determination of paracetamol. RSC Adv 2015. [DOI: 10.1039/c5ra05802c] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
An electrochemical sensor for the sensitive detection of paracetamol (PCM) was developed by constructing a glassy carbon electrode (GCE) modified with multiwalled carbon nanotube–cetyltrimethyl ammonium bromide (MWCNT–CTAB).
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Affiliation(s)
- Jayant I. Gowda
- P.G. Department of Studies in Chemistry
- Karnatak University
- Dharwad-580 003
- India
| | | | - Nagaveni B. Sunagar
- P.G. Department of Studies in Chemistry
- Karnatak University
- Dharwad-580 003
- India
| | - Manjushree N. Bhat
- P.G. Department of Studies in Chemistry
- Karnatak University
- Dharwad-580 003
- India
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12
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Xu R, Wang Q, Zhang J, Zang M, Liu X, Yang J. Changes in pharmacokinetic profiles of acetaminophen and its glucuronide after pretreatment with combinations of N-acetylcysteine and either glycyrrhizin, silibinin or spironolactone in rat. Xenobiotica 2013; 44:541-6. [PMID: 24251357 DOI: 10.3109/00498254.2013.858849] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
1. The present study was to investigate the effects of giving N-acetylcysteine (NAC) alone and in combination with either glycyrrhizin (GL), silibinin (SIB) or spironolactone (SL) on the plasma pharmacokinetic (PK) profiles, hepatic exposure, biliary excretion and urinary excretion of acetaminophen (APAP) and its major metabolite, acetaminophen glucuronide (AG). 2. Groups of rats (n = 5) were pretreated with oral doses of either NAC, NAC + GL, NAC + SIB or NAC + SL on five occasions every 12 h. At 1 h, after the last dose, they received APAP (200 mg/kg) by intraperitoneal injection. Blood, bile, liver and urine samples were collected at various times after APAP injection and analyzed for APAP and AG by HPLC. NAC alone and NAC + SIB did not significantly change the PK profiles of APAP and AG. In contrast, NAC + GL decreased the biliary excretion of APAP and AG leading to accumulation of APAP in the liver and systemic circulation whereas NAC + SL [multidrug resistance associated 2 (Mrp2) inducer] increased the biliary excretion of AG and decreased the hepatic exposure to APAP and AG. 3. Our results suggest that Mrp2 inhibitor GL should be discouraged with NAC to treat APAP hepatotoxicity. Such PK drug-drug interactions should be considered in the treatment of APAP-induced liver injury.
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Affiliation(s)
- Ruijuan Xu
- Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University , Nanjing , China
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13
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Bylda C, Thiele R, Kobold U, Volmer DA. Simultaneous quantification of acetaminophen and structurally related compounds in human serum and plasma. Drug Test Anal 2013; 6:451-60. [DOI: 10.1002/dta.1527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 07/26/2013] [Accepted: 07/27/2013] [Indexed: 01/30/2023]
Affiliation(s)
| | | | - Uwe Kobold
- Roche Diagnostics GmbH; Penzberg; Germany
| | - Dietrich A. Volmer
- Institute of Bioanalytical Chemistry; Saarland University; Saarbrücken; Germany
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Kulys J, Bratkovskaja I, Ašeris V, Baronas R. Electrochemical Peroxidase-Catalase Clark-Type Biosensor: Computed and Experimental Response. ELECTROANAL 2013. [DOI: 10.1002/elan.201300070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Betto MRB, Lazarotto LF, Watanabe TTN, Driemeier D, Leite CE, Campos MM. Effects of treatment with enalapril on hepatotoxicity induced by acetaminophen in mice. Naunyn Schmiedebergs Arch Pharmacol 2012; 385:933-43. [DOI: 10.1007/s00210-012-0774-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 06/14/2012] [Indexed: 12/27/2022]
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16
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Assessment of the Clinical Use of Intravenous and Oral N-Acetylcysteine in the Treatment of Acute Acetaminophen Poisoning in Children: A Retrospective Review. Clin Ther 2011; 33:1322-30. [DOI: 10.1016/j.clinthera.2011.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2011] [Indexed: 01/09/2023]
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17
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Age-related changes in the hepatic pharmacology and toxicology of paracetamol. Curr Gerontol Geriatr Res 2011; 2011:624156. [PMID: 21765826 PMCID: PMC3135080 DOI: 10.1155/2011/624156] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 03/29/2011] [Indexed: 12/20/2022] Open
Abstract
Optimal pharmacotherapy is determined when the pharmacokinetics and pharmacodynamics of the drug are understood. However, the age-related changes in pharmacokinetics and pharmacodynamics, as well as the increased interindividual variation mean optimal dose selection are a challenge for prescribing in older adults. Poor understanding of how hepatic clearance and toxicity are different with age results in suboptimal dose selection, poor efficacy, and/or increased toxicity. Of particular concern is the analgesic paracetamol which has been in use for more than 50 years and is consumed by a large proportion of older adults. Paracetamol is considered to be a relatively safe drug; however, caution must be taken because of its potential for toxicity. Paracetamol-induced liver injury from accidental overdose accounts for up to 55% of cases in older adults. Better understanding of how age affects the hepatic clearance and toxicity of drugs will contribute to evidence-based prescribing for older people, leading to fewer adverse drug reactions without loss of benefit.
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Flores-Pérez C, Chávez-Pacheco JL, Ramírez-Mendiola B, Alemón-Medina R, García-Álvarez R, Juárez-Olguín H, Flores-Pérez J. A reliable method of liquid chromatography for the quantification of acetaminophen and identification of its toxic metabolite N-acetyl-p-benzoquinoneimine for application in pediatric studies. Biomed Chromatogr 2010; 25:760-6. [PMID: 20878659 DOI: 10.1002/bmc.1511] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 07/06/2010] [Accepted: 07/07/2010] [Indexed: 12/27/2022]
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Acetaminophen, Salicylates and Nonsteroidal Anti-inflammatory Drugs. Clin Toxicol (Phila) 2010. [DOI: 10.3109/9781420092264-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Smith SB, Maguire J, Mauck KF. Clinical cases in acute intoxication. Hosp Pract (1995) 2009; 37:84-92. [PMID: 20877175 DOI: 10.3810/hp.2009.12.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Over 2.5 million accidental and intentional drug-related poisonings are reported annually in the United States. Early diagnosis and management of patients who present with acute intoxication can significantly reduce both morbidity and mortality. The initial evaluation of patients with suspected or proven intoxications should focus on hemodynamic stability, mental status, and respiratory function. However, early recognition of toxic ingestion is paramount to implementing life-saving treatments. Important historical clues are often found in a social history that considers intravenous drug use, alcohol use, and any access or exposure to illicit substances. A patient's medication list should also be scrutinized for psychoactive or sedative medications, such as tricyclic antidepressants or opioids. In this article we present case-based discussions of the specific diagnosis and management of 5 commonly occurring acute intoxication syndromes.
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Affiliation(s)
- Sean B Smith
- Mayo Clinic Graduate School of Medicine, Department of Internal Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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Tan HH, Chang CY, Martin P. Acetaminophen hepatotoxicity: current management. ACTA ACUST UNITED AC 2009; 76:75-83. [PMID: 19170221 DOI: 10.1002/msj.20065] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Hui-Hui Tan
- Division of Liver Diseases, Recanati-Miller Transplantation Institute, Mount Sinai School of Medicine, New York, NY, USA.
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